Effect of the Primary Nursing Model on Nurse and Patient Outcomes (PRIMARY-NURSE)

March 14, 2026 updated by: Demet Yurtsever, Istanbul University - Cerrahpasa

The Effect of Implementing the Primary Nursing Model on Nurse and Patient Outcomes: A Quasi-Experimental Study

The aim of this study was to determine the effects of the primary nursing model on nurse and patient outcomes. In the study, primary nursing education was provided to the nurses in the experimental group, and the primary nursing model was implemented in the clinics where they worked. Evaluations were conducted with nurses and patients before the implementation and at the third and sixth months after the implementation.

The study aimed to evaluate the effects of the primary nursing model on missed nursing care, nurses' job satisfaction, nurses' roles and competencies, and patient satisfaction with nursing care.

Hypotheses of the study:

H1-1: There is a significant difference between the evaluations of nurses in the experimental group regarding missed nursing care before the primary nursing implementation and at the 3rd and 6th months after the implementation.

H1-2: There is a significant difference between the job satisfaction evaluations of nurses in the experimental group before the implementation and at the 3rd and 6th months after the implementation.

H1-3: There is a significant difference between the role and competency evaluations of nurses in the experimental group before the implementation and at the 3rd and 6th months after the implementation.

H1-4: There is a significant difference between the evaluations of patients receiving care from nurses in the experimental group regarding missed nursing care before the implementation and at the 3rd and 6th months after the implementation.

H1-5: There is a significant difference between the evaluations of patients receiving care from nurses in the experimental group regarding satisfaction with nursing care before the implementation and at the 3rd and 6th months after the implementation.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Nursing care services constitute one of the fundamental components of health services. Organizing nursing care effectively in hospitals and ensuring continuous care for patients are essential responsibilities of nursing management. Nursing care delivery methods provide a framework for organizing and assigning nursing responsibilities in clinical settings. These methods are closely related to organizational philosophy, nursing management approaches, available resources, and the structure of healthcare services.

Various nursing care delivery models have been developed over time to improve the quality and continuity of nursing care. Traditional nursing care delivery models include total patient care, functional nursing, team nursing, and primary nursing. Among these approaches, the primary nursing model emphasizes accountability, continuity of care, and professional autonomy of nurses.

The primary nursing model assigns a primary nurse to each patient, who is responsible for planning, coordinating, and evaluating the patient's care throughout the hospitalization period. This model promotes continuity of care, improves communication within the healthcare team, and supports nurses' professional autonomy and responsibility. Previous studies have suggested that the primary nursing model may improve nurse-related outcomes such as job satisfaction, role clarity, and professional competence, as well as patient-related outcomes such as satisfaction with nursing care and reduced missed nursing care.

Despite the potential benefits of the primary nursing model, there are limited studies examining its effects in clinical settings, particularly in national healthcare systems. Therefore, evaluating the impact of this nursing care delivery model is important for improving nursing care quality and organizational outcomes.

This study examined the effects of implementing the primary nursing model on nurse and patient outcomes using a quasi-experimental research design. The primary nursing model was implemented in the experimental group units, while the control group continued with the existing nursing care delivery method. Data were collected from nurses and patients before the implementation and at the third and sixth months after the implementation. The study evaluated the effects of the primary nursing model on missed nursing care, nurses' job satisfaction, nurses' roles and competencies, and patient satisfaction with nursing care.

Study Type

Interventional

Enrollment (Actual)

1305

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Küçükçekmece
      • Istanbul, Küçükçekmece, Turkey (Türkiye), 34303
        • İstanbul Kanuni Sultan Süleyman Education and Research Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Nurse Participants Inclusion Criteria

  • Nurses working in the intervention and control units where the primary nursing care delivery model will be implemented
  • Nurses who provide direct patient care
  • Nurses who have been working in the unit for at least 3 months
  • Nurses who voluntarily agree to participate in the study

Exclusion Criteria

  • Nurses working in administrative or managerial positions
  • Nurses who are on leave during the data collection period
  • Nurses who do not consent to participate in the study

Patient Participants Inclusion Criteria

  • Patients hospitalized in the intervention and control units
  • Patients aged 18 years and older
  • Patients who are able to communicate and respond to the questionnaire
  • Patients who voluntarily agree to participate in the study

Exclusion Criteria

  • Patients with severe cognitive impairment or communication problems
  • Patients who are discharged before the data collection process is completed
  • Patients who do not consent to participate in the study

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental group nurses
Nurses in the experimental group will receive training on the primary nursing care delivery model and will implement the primary nursing method in their clinical units during the study period.
Behavioral: Primary Nursing Care Delivery Model
Nurses in the experimental group will receive education on the primary nursing care delivery model. Following the training, the primary nursing method will be implemented in the participating clinical units for six months.
No Intervention: Usual Nursing Care
Nurses in the control group will continue providing care using the existing nursing care delivery method without implementation of the primary nursing model.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Missed Nursing Care measured by the MISSCARE Survey
Time Frame: Baseline, 3 months, and 6 months after implementation
Missed nursing care will be assessed among nurses working in the intervention and control units using the MISSCARE Survey to evaluate the impact of the primary nursing care delivery model.
Baseline, 3 months, and 6 months after implementation
Nurse Job Satisfaction measured by the Clinical Nurses Job Satisfaction Scale
Time Frame: Baseline, 3 months, and 6 months after implementation
Nurse job satisfaction levels will be assessed among nurses working in the intervention and control units using the Clinical Nurses Job Satisfaction Scale.
Baseline, 3 months, and 6 months after implementation
Patient Satisfaction with Nursing Care measured by the Newcastle Satisfaction with Nursing Care Scale
Time Frame: Baseline, 3 months, and 6 months after implementation
Patient satisfaction with nursing care will be assessed among hospitalized patients in the intervention and control units using the Newcastle Satisfaction with Nursing Care Scale.
Baseline, 3 months, and 6 months after implementation
Nurse Role and Competency measured by the Nurses' Role and Competency Scale
Time Frame: Baseline, 3 months, and 6 months after implementation
Nurses' professional roles and competencies will be assessed among nurses working in the intervention and control units using the Nurses' Role and Competency Scale.
Baseline, 3 months, and 6 months after implementation

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Istanbul University - Cerrahpasa

Investigators

  • Principal Investigator: Demet Yurtsever, RN, PhD, Istanbul University-Cerrahpasa, Florence Nightingale Faculty of Nursing, Istanbul, Turkey

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 1, 2022

Primary Completion (Actual)

October 31, 2022

Study Completion (Actual)

October 31, 2022

Study Registration Dates

First Submitted

March 11, 2026

First Submitted That Met QC Criteria

March 14, 2026

First Posted (Actual)

March 16, 2026

Study Record Updates

Last Update Posted (Actual)

March 16, 2026

Last Update Submitted That Met QC Criteria

March 14, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IUC-PN-2024

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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